beam Consultancy

Providing Illumination and Support

Clinical Expertise and Lived Experience in the areas of potentially lethal self harm, suicidality and complex interpersonal dynamics, often coming under the umbrella of ‘personality disorder’

=Who We Are

Beam Consultancy is a unique organisation driven by clinicians and experts by experience. We provide training, consultancy and intervention for those living and working with complex mental health issues.

Beam was founded in response to the realisation that the NHS often struggles to work with those with complex mental health problems, particularly when these problems feature relationship difficulties, self harm and suicidality.

Our clinicians have considerable experience in mental health covering all areas from secure hospitals, PICUs, acute wards and a variety of generic and specialist community teams. We are DBT therapists in addition to our core training. Between us we combine Masters level study of Working with Personality Disorder, publications around working with complex presentations and leading workshops at national conferences. We have won awards for delivering innovative services to complex client groups and are recognised as experts in our field.

Our Experts by Experience have received community and inpatient treatment both voluntarily and under the Mental Health Act. They have experienced individual and group therapy as well as ECT and restraint. Essentially, our experts have exceptional communication skills which allow them to share their experiences without staff feeling blamed or judged. They have experience of delivering treatment as well as supervising staff. They have delivered multiple training sessions with consistent excellent feedback and include award winners for presenting at national conferences.

Our partnership of professional and experiential expertise is a unique service with a proven record of success in psychologically containing staff and service users working/living with complex needs.

Illumination - Consultancy

Significant complexity often leads to teams and individuals experiencing problems and feeling stuck. Our supervision/thinking space sessions are facilitated by those who have worked with and lived with problems identified as extremely high risk. These help to unlock understanding and solutions inherent in our clients.

We offer a risk assessment package to identify where more positive risk taking can take place and where service interventions can maintain or exacerbate issues.

We can work with your organisation to understand the barriers to working effectively and identify solutions to improve service user experience and reduce expenditure.

Support - Therapy

Depending on the client, we offer DBT or intensive goal focused therapy aimed at promoting autonomy and increasing quality of life. Our experts by experience can develop a rapport often inaccessible to professional staff.

Our primary support package is aimed at helping people in their own environment. We recognise the issues identified in the NICE guidelines around out of area placements and our Placement Avoidance package is designed to provide excellent care at an affordable rate without the trauma of leaving the client's social environment.

Training

All of our training packages are jointly created and delivered by those with clinical experience and lived experience of the subject matter. While we are focused on meeting the needs of our clients, our preference is to avoid the dry delivery of facts and instead unlock the skills, knowledge and reflection staff need to perform and excel in their roles.

Working Effectively With People Diagnosed with Personality Disorder - 3 Days

A 3 day course focused on understanding the presentation often labelled as personality disorder. We include the skills required to be effective, including specific approaches to collaborative working, formulation and managing crisis. We aim to develop the reflective mindset essential for working with high risk clients while teaching the skills that our clinicians and service users have found to be effective.

Skills for working with People Diagnosed with Personality Disorder- 1 day

An abridged 1 day version of the above 3 day course with specific focus on the importance of building relationships, collaborative working, deescalation, interpersonal dynamics, validation, problem solving and effectively utilising DBT techniques.

Working with potentially lethal self harm - 2 Days

This 2 day course specialises in understanding and working with potentially lethal self harm. With emphasis on harm reduction, risk management without being risk adverse, and how to provide psychological containment for both clinicians and clients. This is delivered from a unique perspective of a client's frame of reference to understand the underlying reasons for 'maladaptive' ways of coping.

A 1 day course concentrating on effectively managing crisis by understanding what is behind the presentation; illuminating what is being communicated by clients and sometimes reflected back by teams. There is a focus on developing skills to provide psychological containment for both clinicians and clients in emotionally charged situations and effectively utilising de-escalation techniques and risk management. Sessions will cover validation, problem solving and a range of skills to employ including 'When nothing seems to work'.

Why it all makes sense: Formulating Behaviour that causes problems - 1 day

Understanding how early life and past experiences are reaffirmed and play out in the present. Using theory that is accessible and understandable for all levels of staff, we will jointly create a narrative to facilitate insight and aid problem solving.

An introduction to mental health - 1 day

A brief overview of mental health generally; exploring wellness and illness, diagnosis, dispelling myths, and common interventions used within primary and secondary services. How you can help and how to refer on.

Restraint: The power of being held - 1 day

Exploring psychologically informed ways of minimising the use of restraint within inpatient facilities using effective communication and de-escalation with attention paid to a client's previous experiences and how those are played out in the present..

Thinking the unthinkable - Various

A facilitated discussion that examines and deconstructs established wisdom. Often used in a conference setting or as a team away day this gives staff the opportunity to play with concepts that are difficult to articulate in the workplace. Previous topics have included "Why are People with Personality Disorder so Manipulative", "Let's Allow Self Harm on the Ward" and "Personality Disorder is not our Business". We can create an engaging and lively debate that is relevant to you.

Bespoke Training Solutions - Various

You know your organisation best and we are eager to hear your training needs and respond to them. We are confident in our skills and experience in working with highly complex and high risk clients, however we are humble enough to direct you to other services if that expertise is located elsewhere. Feel free to contact us to discuss your needs and how we might meet them.

Facilitated Meetings/Away Days

Our presence can help teams in new ways and our Experts by Experience are adept at helping clinicians express ideas they might normally articulate. By working on what people think, as opposed to what they want people to think they think, teams are more able to address the issues facing them. We offer bespoke sessions or can facilitate entire days of team building and reflection.

Consultancy

When working with human beings, the emotional impact of caring for those who find it hard to accept care can be profound. Often our clientele have been let down, neglected and/or abused by those who might have been expected to protect them. This leads to difficulties in their ongoing relationships with health professionals.

Individual/Team Supervision

A regular space to discuss the difficulties of the work, the impact on the staff and service user and essentially, a plan of action to move forward. Jointly facilitated by our expert clinicians and experts by experience, the sessions promote an empathic understanding of difficulties, and focus on thoughtful responses based on facts rather than traditional thoughts or prescribed beliefs.

Complex Case discussion

A stand alone case conference to identify the goals, risks, learning opportunities and ways forward for teams and clients who are particularly stuck. Our service user consultants help to bring an authentic understanding of challenging presentations and the potential impact and interpretations of what we consider care. These sessions are aimed at developing a more nuanced understanding of complexity, building a team formulation and using this as the basis for further decision making.

Independent assessment and risk formulation

It is our firm belief that the knowledge and solutions for working with complex clients lie within the treating team. On occasion teams benefit from a new perspective to enrich their understanding of their client. We offer a review of clinical notes, interview with the client and a risk formulation based on what is likely to occur consistent with previous actions and opposed to basing interventions on the worst possible scenario. We focus on the client's strengths, safety behaviours, capacity to make decisions and potential for long term improvement verses short term relief. From this we can outline a strategy for ongoing treatment that allows the client to retain autonomy while maintaining coping methods that are potentially harmful. Often interventions aimed at keeping people safe can inadvertently lead to increased self harm and potentially higher risk of death.

Organisational Observation & Consultation

At times staff are aware that there are difficulties in their environment but find it hard to articulate them so that they can be worked on. This can lead to splits in the team, locating problems in individuals or increased sickness and burnout. This package involves our experts spending time to observe, speak to those in the environment and feedback observations in a way the team can understand and action.

Support

We passionately believe that sustainable recovery takes place in the client's home environment. All of the NICE guidelines' personal accounts talk of people going to various placements only to relapse when they return to home. Our interventions are aimed at people with significant levels of self harm and perceived high risk of suicide and prioritise doing things via negotiation and consent while avoiding coercion and control.

Placement Avoidance

This package is based on the NICE recommended therapy, DBT, and prioritises reducing potentially lethal behaviour, maintaining a therapeutic relationship and building a life worth living. Our intensive psychological containment model offers twice weekly sessions combined with 24 hour telephone support. We will help our clients to use the services around them effectively while providing the majority of their therapeutic contact.

Our team have experience of working effectively and informally in the community with those who it was felt that compulsory out of area therapy was the only option. In addition we have successfully transitioned people from secure units to the community where there were strong views that only compulsory detention could be provided. Our clinicians and Experts by Experience are keenly aware of the effects of iatrogenic harm - where what is done for the best results in maintaining/exacerbating problems, and we will work intensively with teams and clients to minimise these dynamics.

Where clients are unable to commit to DBT we offer a similarly intensive, goal focused intervention based around Structured Clinical Management. This is an approach with a comparable evidence base to DBT but without the requirement to give up self harm. We would work with clients to build a life worth living incorporating their views about their essential coping mechanisms. In the past our support has moved clients off wards where placement was considered the sole option, to over a year in the community receiving our support without admission.

While we are confident that we provide an effective, ethical and evidence based service our unique selling point is that we will deliver consensual, collaborative care at a fraction of the cost of enforced residential treatment.